PLANNING

As COVID Cloud Clears, Hospital Strategists Take a Fresh Look at Future Facility Plans
While the popularity of digital and ambulatory options has reshaped the landscape, optimizing investments continues to remain key.

As COVID-19’s cloud begins to lift this summer, the pandemic is leaving behind lasting lessons when determining physical space needs in the new normal.

Patients have built new habits of receiving care at home, via video or in lower-acuity settings such as urgent care centers — trends already taking root for years to come. Hospital strategists are now envisioning the health facility of the future while also staying mindful of potential future public health crises.

“One of the important lessons COVID-19 taught us is how to be flexible, open to new ideas and pivot quickly,” said Jennifer Weiss Wilkerson, vice president and chief strategy officer at Sheppard Pratt.

Following COVID’s arrival, the Maryland-based behavioral health services provider has seen telehealth visits increase 14,000% compared to pre-pandemic numbers. Sheppard Pratt was able to quickly procure technology, establish new processes, train staff and educate patients within days — which might have taken months during normal times, Wilkerson stated.

While some patients have embraced the shift, others are anxious to return to in-person treatment. Sheppard Pratt and its strategy team are now determining how these last 16-plus months will reshape future facility planning for the next 16 and beyond.  

“It will be important to evaluate what has worked well and what needs to change, so we can continue to offer a broad range of solutions that work for both patients and providers and are sustainable in the long-term,” she said.

Transformation Talks
SHSMD sister organization, the American Society for Health Care Engineering (ASHE) recently hosted a new “Transformation Talk” exploring post-COVID facility planning. Designing with flexibility in mind, reexamining surge capabilities, and reconsidering patient flow/separation are all top-of-mind considerations based on a recent ASHE poll of the field.

The American Hospital Association (AHA) personal membership group’s most recent construction survey found that a year into the pandemic, 33% of health care respondents are moving forward with permanent construction projects related to COVID-19. Hospitals are primarily focused on renovations rather than new construction and outpatient versus inpatient initiatives.

Providence strategy leaders have emphasized cross-collaboration with facility and other system experts during the pandemic. With the Renton, Washington-based organization accelerating digital and technology-based initiatives over the past year, information technology has also served as a key partner to evaluate consumers’ evolving expectations, said Lisa Crockett, executive director of strategy and planning.

The shift toward digital and lower-acuity settings of care means master-site planning is undergoing its own transition at Providence.

“Health care providers are tasked with carefully considering whether building a new bricks-and-mortar facility or reinvesting in the replacement of an existing facility, is the optimal solution,” Crockett said. “These are difficult cases to make, and every dollar counts when evaluating facility infrastructure needs against longer-term strategic, operational and financial priorities. While the natural inclination is to think that shifting care to lower acuity settings means operating from a smaller physical footprint, that’s not always the case.”

She gave the example of total joint replacement surgeries transitioning away from traditional hospital settings toward outpatient surgery centers. In some instances, this may mean ambulatory operating room sizes need to expand, rather than contract, depending on guidelines from state entities and accreditation organizations. As new lower-acuity care settings are designed and constructed, providers should ensure these new facilities are adaptable to future uses when the market may pivot again, Crockett added.

Ownership is also a key consideration and hospitals must evaluate whether they want sole possession of their physical spaces, or if a leasing/joint venture arrangement makes more sense in 2021 and beyond.

“Ultimately, the goals of a master-site facility plan need to align with the aims of your strategic plan,” Crockett said. “This ensures the necessary infrastructure across the full continuum of care is present to support emerging strategic priorities and to maximize the useful life of each facility.”

Behavioral health has emerged as a massive need post-pandemic, as millions of Americans grapple with the aftereffects of prolonged isolation and trauma from losing loved ones due to the virus. Sheppard Pratt is now working to open a $100 million new campus this summer, replacing an aging leased building. They’re adding inpatient beds, four new specialized outpatient programs and psychiatric urgent care, among other upgrades.

“There is a lot of ongoing discussion about behavioral health needs increasing during and after the pandemic,” Wilkerson said. “Some of that can be addressed via telehealth and outpatient offerings, but there is definitely still a huge need for facility development.”

 

This article features interviews with:

Lisa Crockett
Executive Director, Strategy and Planning
Providence
Renton, Washington

Jennifer Weiss Wilkerson
Vice President and Chief Strategy Officer
Sheppard Pratt
Baltimore, Maryland